Provider Demographics
NPI:1538464029
Name:CANDIDO, CAROLYN ALUDINO (MD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ALUDINO
Last Name:CANDIDO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5814 VAN ALLEN WAY STE 215
Mailing Address - Street 2:STE. 215
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-7360
Mailing Address - Country:US
Mailing Address - Phone:760-444-5544
Mailing Address - Fax:
Practice Address - Street 1:5814 VAN ALLEN WAY STE 215
Practice Address - Street 2:STE. 215
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-7360
Practice Address - Country:US
Practice Address - Phone:760-444-5544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA132125207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program